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Senate panel adopts amendment on pharmacy reimbursement; PBM transparency debate continues
Summary
The committee adopted a substantial A6 amendment to SF 3299 to establish a standardized pharmacy‑reimbursement formula, ban spread pricing and require PBM transparency. Independent pharmacists pushed the bill as a lifeline for rural pharmacies while PBMs warned of higher point‑of‑sale costs and premium impacts; the committee laid the bill over for further Commerce review.
Senate File 3299, a broad proposal to address pharmacy closures and opaque pharmacy-benefit manager (PBM) practices, received detailed consideration April 8 and the committee adopted an extensive A6 amendment that added a standardized reimbursement formula, bans on spread pricing and post-claim clawbacks, network adequacy requirements and a bridge-payment mechanism for prior appropriations.
Sponsor and amendment: Senator Man said pharmacies across Minnesota are closing amid reimbursement shortfalls, and the A6 amendment was presented as a package to curb predatory PBM practices and preserve community pharmacy access. The amendment sets a reimbursement benchmark tied to publicly available acquisition-cost measures, establishes a floor for professional dispensing fees and creates transparency and reporting obligations for PBMs.
Pharmacists’ testimony: Independent pharmacists and trade groups testified the commercial market still allows below-cost reimbursements and inadequate dispensing fees, forcing closures in rural communities. Andrew Russell, representing independent pharmacies, described pharmacy closures and said the bill would use objective, publicly available benchmarks to align reimbursement with actual acquisition costs.
PBM and insurer concerns: Michelle Mack of the Pharmaceutical Care Management Association and PBM representatives warned that a mandatory minimum dispensing fee and the reimbursement mandates would increase point-of-sale costs for patients and could raise premiums in the fully insured market. Mack cited an analysis estimating a sizable near‑term increase in dispensing-fee spending and projected higher costs to employers and patients if fees rise uniformly.
Committee action and next steps: After adopting the A6 amendment the committee laid SF 3299 over so PBM-specific oversight and market-impact provisions can be further vetted in Commerce, where technical rulemaking and jurisdictional questions will be examined before any final committee recommendation.
